How much rates vary
Facilitymedian $145 · 10th to 90th $76 to $219Professionalmedian $138 · 10th to 90th $72 to $447
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $457.09 | Professional | None | $77.62 | $123.03 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $389.05 | Professional | None | $112.20 | $199.53 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $213.80 Typical High $288.40 | Facility | None | $165.96 | $213.80 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $251.19 | Professional | None | $72.44 | $72.44 | $251.19 |
DeanCare Setting Facility Modifier None Typical Low $63.10 Median $81.28 Typical High $147.91 | Facility | None | $63.10 | $81.28 | $147.91 |
DeanCare Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $194.98 | Professional | None | $123.03 | $144.54 | $194.98 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $102.33 Typical High $147.91 | Facility | None | $63.10 | $102.33 | $147.91 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $275.42 Typical High $489.78 | Professional | None | $89.13 | $275.42 | $489.78 |
Network Health Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Facility | None | $117.49 | $117.49 | $158.49 |
Network Health Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $181.97 | Professional | None | $102.33 | $158.49 | $181.97 |
Prevea360 Setting Facility Modifier None Typical Low $63.10 Median $81.28 Typical High $147.91 | Facility | None | $63.10 | $81.28 | $147.91 |
Quartz Setting Professional Modifier None Typical Low $83.18 Median $165.96 Typical High $288.40 | Professional | None | $83.18 | $165.96 | $288.40 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $109.65 | Professional | None | $72.44 | $72.44 | $109.65 |
Security Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Security Health Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $389.05 | Professional | None | $95.50 | $154.88 | $389.05 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $275.42 | Professional | None | $75.86 | $120.23 | $275.42 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $61.66 Typical High $229.09 | Professional | 52 · Reduced service | $38.90 | $61.66 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $24.55 Typical High $91.20 | Professional | 53 · Discontinued | $15.49 | $24.55 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $18.20 Typical High $69.18 | Professional | 55 · Aftercare only | $11.48 | $18.20 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.30 Typical High $45.71 | Professional | 56 · Pre-op care only | $7.76 | $12.30 | $45.71 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $22.91 Typical High $30.90 | Professional | 80 · Assistant surgeon | $19.50 | $22.91 | $30.90 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $22.91 Typical High $30.90 | Professional | 81 · Minimal assistant surgeon | $19.50 | $22.91 | $30.90 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $22.91 Typical High $30.90 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $22.91 | $30.90 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $19.95 Typical High $26.92 | Professional | AS · PA/NP assist | $16.98 | $19.95 | $26.92 |
Where Wisconsin sits
The same service costs 3.0 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wisconsin· 7th of 51
$138
AK $195FL $64.57
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.